Microscopic versus endoscopic pituitary surgery

Autores de IIS La Fe

• Juan Antonio Simal Julian

  Autor

• Pablo Miranda Lloret

  Autor

• Rocio Evangelista Zamora

  Autor

• Pedro Perez Borreda

  Autor

• Pablo Sanromán Álvarez

  Autor

• Rosa Cámara Gómez

  Autor

• Carlos Botella Asuncion

  Autor

Participantes ajenos a IIS La Fe

• Pancucci G

Grupos

• Investigación Clínica y Traslacional en Cáncer

  

  Leader

  José Gómez Codina

• Unidad Mixta de Investigación en Endocrinología, Nutrición y Dietética clínica

  Leader

  Juan Francisco Merino Torres

Abstract

Introduction and objective: The endoscopic techniques used in pituitary surgery have evolved greatly in recent years. Our objective in this study was to conduct a review of the systematic reviews published in the English language literature, to examine their consistency and conclusions reached following studies comparing microsurgery and endoscopic surgery in hypophyseal surgery. Materials and methods: We carried out a bibliographic search on MEDLINE and EMBASE electronic databases, selecting those systematic reviews and meta-analyses published from the year 2000 until January 2013, focusing on comparisons between microsurgical and endoscopic techniques. Results: We concluded with type A consistency that hospital stay was shorter and diabetes insipidus and rhinological complications were less frequent in the endoscopy group. We concluded with type B consistency that lower rates of patient blood loss, shorter operative times, higher rate of gross total resection, lesser association to visual impairment and lower rate of hypopituitarism were observed in the endoscopy group. Vascular complications and cerebrospinal fluid fistulas were reduced with microsurgery. It is crucial to perform a combined analysis of all the systematic reviews treating a specific topic, observing and analysing the trends and how these are affected by new contributions. Conclusion: Randomized multicenter studies are necessary to resolve the controversy over endoscopic and microsurgical approaches in hypophyseal pathology. (C) 2013 Sociedad Espanola de Neurocirugia. Published by Elsevier Espana, S.L. All rights reserved.

Keywords

• Pituitary adenoma; Microscopic surgery; Endoscopic surgery